| NPI | 1215718697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA BONACORSO Executive Administrator 435-255-3285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2026-08-31 |